Dental Consult before Bone Marrow Transplant

Dental Consult before Bone Marrow Transplant

Dear OncoLink "Ask The Experts,"

I was told by my new oncologist to see an oral surgeon before my autologous stem cell transplant. The surgeon took x-rays and said that all my teeth had to come out before I could have my transplant. He said 18 teeth were bad, and he would have to pull my good ones too. I saw other patients whose teeth were worse than mine, but they still kept them. Is it necessary to have had all this done, regardless of how I felt?

The reason for a dental consult before a transplant, and often before any treatment for leukemia, is that teeth can harbor infection. It may seem from the outside that teeth are healthy, but underneath there may be areas of decay where infections can hide. When going through a transplant, infections can actually be life-threatening, and so we do our best to prevent them from happening. Unfortunately, one of these preventive ways is by removing cracked, damaged, or infected teeth. In my 13 years as an oncology nurse, I have only seen one patient with all of his teeth removed, but I have seen many who had to lose most of their teeth. This may be upsetting for some patients, but it is far worse if the teeth develop an abscess during treatment.